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Adjustment to Cancer: Anxiety and Distress (PDQ®)

Patient Version
Last Modified: 08/31/2011

Psychological and Social Distress

Key Points for This Section


Feelings of emotional, social, or spiritual distress can make it hard to cope with cancer treatment.

Almost all patients living with cancer have feelings of distress. Feelings of distress range from sadness and fears to more serious problems such as depression, panic, feeling uncertain about spiritual beliefs, or feeling alone or separate from friends and family.

Patients who are in distress during any phase of cancer need treatment and support for their distress. Patients are more likely to need to be checked and treated for distress during the following periods:

Patients who are having trouble coping with cancer may find it helpful to talk with a professional about their concerns and worries. These specialists include:

Patients who are in distress can be helped by different kinds of emotional and social support.

Studies have shown that patients who are having trouble adjusting to cancer are helped by treatments that give them emotional and social support, including:

These types of treatment may be combined in different ways for one or more sessions. Studies have shown that patients with cancer who receive such therapies receive benefits compared to those who do not receive these therapies. Benefits include having lower levels of depression, anxiety, and disease- and treatment-related symptoms, as well as feeling more optimistic. Patients who have the most distress seem to get the most help from these therapies. However, patients who received these therapies did not live longer than those who did not receive them.



Glossary Terms

anxiety (ang-ZY-eh-tee)
Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
clinical trial phase (KLIH-nih-kul TRY-ul fayz)
A part of the clinical research process that answers specific questions about whether treatments that are being studied work and are safe. Phase I trials test the best way to give a new treatment and the best dose. Phase II trials test whether a new treatment has an effect on the disease. Phase III trials compare the results of people taking a new treatment with the results of people taking the standard treatment. Phase IV trials are done using thousands of people after a treatment has been approved and marketed, to check for side effects that were not seen in the phase III trial.
cope (kope)
To adjust to new situations and overcome problems.
counseling (KOWN-suh-ling)
The process by which a professional counselor helps a person cope with mental or emotional distress, and understand and solve personal problems.
counselor (KOWN-seh-ler)
A specialist who talks to patients and their families about emotional and personal matters, and can help them make decisions. Also called mental health counselor.
cure (kyoor)
To heal or restore health; a treatment to restore health.
depression (dee-PREH-shun)
A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.
diagnosis (DY-ug-NOH-sis)
The process of identifying a disease, such as cancer, from its signs and symptoms.
distress (dih-STRESS)
Extreme mental or physical pain or suffering.
mental health (MEN-tul helth)
A person’s overall psychological and emotional condition. Good mental health is a state of well-being in which a person is able to cope with everyday events, think clearly, be responsible, meet challenges, and have good relationships with others.
palliative care (PA-lee-uh-tiv kayr)
Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of palliative care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, supportive care, and symptom management.
palliative therapy (PA-lee-uh-tiv THAYR-uh-pee)
Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.
panic (PA-nik)
Sudden extreme anxiety or fear that may cause irrational thoughts or actions. Panic may include rapid heart rate, flushing (a hot, red face), sweating, and trouble breathing.
psychologist (sy-KAH-loh-jist)
A specialist who can talk with patients and their families about emotional and personal matters, and can help them make decisions.
quality of life (KWAH-lih-tee ... life)
The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.
relaxation technique (ree-lak-SAY-shun tek-NEEK)
A method used to help reduce muscle tension and stress, lower blood pressure, and control pain. Examples of relaxation techniques include tensing and relaxing muscles throughout the body, guided imagery (focusing the mind on positive images), meditation (focusing thoughts), and deep breathing exercises.
remission (reh-MIH-shun)
A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body.
social support (SOH-shul suh-PORT)
A network of family, friends, neighbors, and community members that is available in times of need to give psychological, physical, and financial help.
social worker (SOH-shul WUR-ker)
A professional trained to talk with people and their families about emotional or physical needs, and to find them support services.
spirituality (SPEER-ih-choo-A-lih-tee)
Having to do with deep, often religious, feelings and beliefs, including a person’s sense of peace, purpose, connection to others, and beliefs about the meaning of life.
symptom (SIMP-tum)
An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.
talk therapy (...THAYR-uh-pee)
Treatment of mental, emotional, personality, and behavioral disorders using methods such as discussion, listening, and counseling. Also called psychotherapy.
therapy (THAYR-uh-pee)
Treatment.